Rate Benchmarking
Compare your rates with similar providers.
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonCPT 29856 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.
Repair Broken Shinbone, Surgery Aided By A Scope (Arthroscope) To Repair A Broken Shinbone. The Bones May Be Moved Into Place Manually Or Held In Place Using Pins Wires Or A Cage Just Below The Knee.
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 22 - On Campus Outpatient Hospital 24 - Ambulatory Surgical Center |
| Common Modifiers | None LT - Left side of body RT - Right side of body |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 29856 |
| Medicaid Fee Schedule | View Medicaid rates for 29856 |
National average reimbursement for CPT 29856 by major payers:
$1,355.03
$1,184.12
$1,031.52
$1,628.95
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 29856.
CPT 29856
5 of 25 sample ratesHigher to lower in this preview
Lakewalk Surgery Center, Inc.
Lakewalk Surgery Center Inc.
$9,345.00Published rateHealtheast Surgery Center-Maplewood, LLC, Maplewood Surgery Center
Healtheast Surgery Centermaplewood LLC
$6,082.00Published rateBjosc, LLC, Bjosc, LLC @ Westwood
Bjosc LLC
$4,240.00Published ratePacific Gastroenterology Endoscopy Center
$3,000.00Published rateDelta Endoscopy Center, P.C.
Delta Endoscopy Center PC
$1.00Published rate
Get a free rate benchmark for your specialty.
Choose your state and specialty to build a report from payer-published rates.
Use market rates to prepare your payer proposal.
Payer Contract Negotiation
Draft a fee schedule renegotiation letter.
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 29856 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 29856 code is part of the Surgery services used for Surgical Procedures on the Musculoskeletal System. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 29856 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 29851-CPT | High | Fracture Treatment, Arthroscopically Aided Treatment Of Intercondylar Spine(S) And/Or Tuberosity Fracture(S) Of The Knee With Or Without Manipulation; Without Internal Or External Fixation (Includes Arthroscopy) With Internal Or External Fixation (Includes Arthroscopy) |
| 29855-CPT | High | Repair Broken Shinbone, Surgery Aided By A Scope (Arthroscope) To Repair A Broken Shinbone. The Bones May Be Moved Into Place Manually Or Held In Place Using Pins Wires Or A Cage Just Below The Knee. |
| 29856-CPT | High | Repair Broken Shinbone, Surgery Aided By A Scope (Arthroscope) To Repair A Broken Shinbone. The Bones May Be Moved Into Place Manually Or Held In Place Using Pins Wires Or A Cage Just Below The Knee. |
| 29866-CPT | High | Autgrft Implnt Knee W Scope, Arthroscopy Knee Surgical Osteochondral Autograft S Eg Mosaicplasty Includes Harvesting Of The Autograft S |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 29856. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 29856 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
FREE SAMPLE MARKET COMPARISON
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 29856) and we'll show you how you compare in 15 minutes or less.